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Short and Sweet Birth Plan

Name/Care Provider/Doula

We’re planning an unmedicated birth.  It is our belief that birth is a normal process; not usually a medical emergency and proceeds in the safest manner without interventions.  Please assist us by offering the least amount of intervention in this normal process. 

  • I plan to stay active.
  • I would like voices to be kept quiet; especially during contractions.
  • I would like to give birth in a vertical position like squatting or hands/knees.
  • I would like to follow my own cues for pushing.  Please do not direct me unless baby is in distress or I request it.
  • I would like immediate skin-to-skin contact with my baby.
  • Please allow the cord to stop pulsing before clamping.
  • I do not want routine Pitocin for third stage unless I show signs of excessive bleeding.
  • Delay all newborn procedures for an hour after birth.

Thanks for your support in our birth experience,

Signature of couple

Signature of care provider

2 responses »

  1. may I steal this for my website that pretty much sucks because I have no idea what I am doing and Pete is no help at all? Please?


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